NPIMap

Individual provider Active NPI

Samuel Shelburne, MD

  • Infectious Disease Physician
  • Houston, TX
National Provider Identifier
1841389319
Registry record updated Jan 22, 2021
On this page

Key facts

NPPES NPI Registry
Primary specialty
Infectious Disease PhysicianTaxonomy code 207RI0200X
License
L2641 Issued in TX
Practice address
1515 Holcombe Blvd
Houston, TX 77030-4009
Phone
(713) 792-6161
NPI assigned
Oct 12, 2006
Last updated
Jan 22, 2021By the provider in NPPES
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jan 22, 2021

Registry information is reported by the provider to CMS and is not verified. About this source

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Infectious Disease Physician 207RI0200X L2641 TX Primary

Addresses

Primary practice location

1515 Holcombe Blvd
Houston, TX 77030-4009

Mailing address

PO Box 4439
Houston, TX 77210-4439
Phone (713) 792-2991

Other identifiers 4

IdentifierTypeStateIssuer
173567205OtherTXMEDICAID-CSHCN
P00876959OtherTXRR MEDICARE (MDACC)
173567204 (MDACC)MedicaidTX
8U4296OtherTXBCBS (MDACC)

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in TX
Eligible to order & refer
  • Part B services
  • Medical equipment
  • Home health
  • Power mobility devices
  • Hospice
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20050624000001 TX Practitioner - Infectious DiseasePractitioner - Internal Medicine 8820033442 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Infectious DiseaseAlso: Internal Medicine
Education
University of Texas Medical Branch at Galveston, 1998
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Telehealth
Offers telehealth services
Group practices
Physicians Referral ServiceGroup PAC ID 7911801410, 2,728 clinicians

Practice addresses (Care Compare)

2130 W Holcombe Blvd
Univ of TX M D Ande Life Sciences Plaza
Houston, TX 77030-4009
Phone (713) 592-5433

Hospital & facility affiliations

Merit-based Incentive Payment System (MIPS)

Final score
84.29 of 100Reported as group
Quality
70.82
Promoting interoperability
100
Improvement activities
40
Cost
67.65

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Doctor of Medicine

State licenses

LicenseStateTypeSpecialty
L2641TXMDInfectious Disease Physician

Practice roles

OrganizationSpecialtyStatusNew patients
Physicians Referral Service CurrentSince Aug 4, 2008 Accepting new patients
Baylor College of Medicine PastSince Jan 1, 1990 Accepting new patients
Diagnostic Virology Laboratories PastSince Jan 1, 1990 Accepting new patients
Baylor College of Medicine Teen Health Clinic PastSince Jan 1, 1990 Accepting new patients
Diagnostic Virology Lab PastSince Jan 1, 1990 Accepting new patients
Baylor College of Medicine Teen Health Clinic PastSince Jan 1, 1990 Accepting new patients
Baylor College of Medicine PastSince Jan 1, 1990 Accepting new patients
Baylor College of Medicine PastSince Jan 1, 1990 Accepting new patients
Baylor College of Medicine Teen Health Clinic PastSince Jan 1, 1990 Accepting new patients
Baylor Colleg of Medicine Teen Health Clinic PastSince Jan 1, 1990 Accepting new patients
Baylor College of Medicine Teen Health Clinic PastSince Jan 1, 1990 Accepting new patients
BCM Clinic Lab PastSince Jan 1, 1990 Accepting new patients
Baylor College of Medicine Teen Health Clinic PastSince Jan 1, 1990 Accepting new patients

Locations

1515 Holcombe Blvd
Houston, TX 77030
Phone (713) 794-5446

1515 Holcombe Blvd
#R4212
Houston, TX 77030
Phone (713) 794-5446

Interoperability endpoints

  • Direct secure messaging: sshelburne15225@utmdandersoncc.direct-ci.com

Organizations & group practices 13

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships, National Provider Directory roles and organizations whose NPPES authorized official is this provider.

View all 13

Hospital & facility affiliations 1

Hospitals and other facilities this clinician is affiliated with according to Medicare Care Compare.

NPI Registry JSON

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1160611200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1611273600000",
    "number": "1841389319",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 4439",
            "city": "HOUSTON",
            "state": "TX",
            "postal_code": "772104439",
            "telephone_number": "713-792-2991"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1515 HOLCOMBE BLVD",
            "city": "HOUSTON",
            "state": "TX",
            "postal_code": "770304009",
            "telephone_number": "713-792-6161"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "SHELBURNE",
        "first_name": "SAMUEL",
        "credential": "MD",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2006-10-12",
        "last_updated": "2021-01-22",
        "certification_date": "2021-01-22",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "207RI0200X",
            "taxonomy_group": "",
            "desc": "Internal Medicine, Infectious Disease",
            "state": "TX",
            "license": "L2641",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "MEDICAID-CSHCN",
            "identifier": "173567205",
            "state": "TX"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "RR MEDICARE (MDACC)",
            "identifier": "P00876959",
            "state": "TX"
        },
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "173567204 (MDACC)",
            "state": "TX"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "BCBS (MDACC)",
            "identifier": "8U4296",
            "state": "TX"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Houston, TX

Sources for this page

Verify at the official NPI Registry.